Tx! MAG #26

SO WHAT'S THIS "IMPORTANT" THING YOU WANNA TELL ME...?

edition

26

JUN 2017

UMMM...

OUR IRST F Y R VE

B P E H !

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A WORD FROM THE EDITOR! Hey Tx!-ians!

Welcome to edition #26 of Tx! Mag. This is our first ever issue focusing on hepatitis B. Even though it is a virus that effects the liver - potentially resulting in cirrhosis and cancer - it is very different from hepatitis C. Unlike hep C, there is a vaccine for hep B; and while there are treatments for hep B there is currently no cure. Hep B has some similar transmissions paths to hep C (namely through blood to blood contact) but also different paths too (for example, from mother-to-baby at birth, and sexual fluids.)

In this edition we have two stories. One is about Gina, who receives some unexpected news from her ex boyfriend; the second story is about Mick who learns that his immune system has started attacking his hep B... which could spell bad news for his liver! Please enjoy their stories.

Cheers!

Grace Tx! Mag Ed Aside from Hepatitis NSW editorial content, views expressed in this magazine or flyers enclosed with it are not necessarily those of Hepatitis NSW or the organisations with whom we collaborate. Neither are such views necessarily those of our funding bodies.

Tx! Mag does not promote or condone the use of illicit drugs. Rather, it seeks to provide accurate information that will help people who already use drugs to reduce risks and make safer choices. Nothing in this magazine should be taken as recommending drug use.

Hepatitis NSW is proud to acknowledge Aboriginal people as the traditional owners and custodians of our lands and waters.

EDITOR/DESIGNER Grace Crowley EDITORIAL COMMITTEE Tim Baxter Ben Cork Jenny Douglas Paul Harvey Alastair Lawrie Sonam Paljor Lucy Pepolim Kate Pinnock Rhea Shortus Robert Wisniewski SPECIAL THANKS Kyle Leadbeatter Simone Strasser Jacob George STORY WRITERS Lawrence Gergich (Can't B Happening) Charlie Foster (One Step at a Time) COMIC ARTISTS Daryl Toh (Can't B Happening) Skye Ogden (One Step at a Time) gestaltcomics.com

Hepatitis Infoline 1800 803 990 (freecall) Hepatitis NSW p: 02 9332 1853 e: info@hep.org.au w: hep.org.au fb: facebook.com/HepNSW tw: @HepatitisNSW PO Box 432 Darlinghurst, NSW 1300 ABN 30 408 095 245 A non-profit health promotion charity funded by the NSW Ministry of Health. Accredited by the Quality Improvement Council of Australia (QIC). Donations of $2 and over are tax deductible.

Can’t “B” Happening

Huh? Oh, yeah, you’re right Fatima.

| think you’ve done that wrong, Gina. Green is earth, not neutral.

Mount Druitt TAFE, electrical workshop.

Good thing the boys didn’t see or we’d never hear the end of it.

Who cares what they think?

Well |’d care if you got yourself electrocuted.

Yeah.

Sorry, been feeling a bit off this week.

Tired and like | want to hurl.

Nah, |’ll be fine.

You gonna see a doctor?

1

You not eating?

Not hungry.

Just not hungry, okay?

Still not well?

Hey, look. It’s Kapo. {sigh} You two not talking again?

Good luck to him. |’m not interested. | told him last week it’s over for good this time.

Well, he sure looks like he wants to talk to you.

Hi Fatima ...uh, hi Gina.

Um, hey can we talk.

In private...?

No, |’ve got nothing to say.

We’re over, Kapo.

It’s not that.

Look, this is really important.

Can we talk?

Please?

2

To do what?

Okay.

What’s so damned important mister “Amazing Engineering Student”?

| get it, okay. |’m only doing this because my doctor told me to.

This better not be you trying to get back into my pants.

To tell you |’ve got hepatitis B.

Hep B. It’s a virus that can damage the liver. |’m sorry, | didn’t know | had it.

Apparently | got it from my mum when | was born.

We only found out she had it recently because they found out she has liver cancer.

"Hepa"-what?

And then they tested me and my brothers and sisters.

That sucks.

Sorry to hear it, Kapo. Really.

But what’s it got to do with me?

3

Three days later.

...and so he said because we’d been in a relationship and, y’know, did it... that | should get a test for hep B.

Okay, so hepatitis B is most often passed on ...but it can from mother to also be passed on baby... through blood to

So... not using condoms?

blood contact, like sharing needles when injecting drugs--

Yes.

Uh, we might’ve done that a couple of times.

We never did any of that.

Look, can’t | get a vaccine for it or something?

Or through sexual fluids from having sex without protection.

Unfortunately it might be too late for that, Gina.

|’m going to send you for a full screen of tests, okay? BBVs, STIs*, the works.

Fuck.

This can’t be happening.

Okay, doc.

4

BBVs: Blood Borne Viruses STIs: Sexually Transmitted Infections

Morning.

Why so glum?

Didn’t you do your reading for class?

What?

How? Don’t know if | should get close to you.

Uh... confidential.

Just be careful. |’d hate to give it to you.

| might have hep B.

Don’t be silly.

Listen to you, “Ms Hep B Expert”!

Even if you have it, |’m not going to get it from being near you.

Or touching you or things that you’ve touched.

My uncle has had it his whole life.

Or even sharing food for that matter.

His whole life?

There’s no cure for it yet.

He’s okay though, he just needs to get tested a couple of times a year to make sure his hep B isn’t acting up and his liver is alright.

Shit.

Sorry Fatima.

That must be tough.

God, what if | have got this thing and |’m stuck with it forever just like Kapo and your uncle?

5

|’m sorry to say that you’ve tested positive for hepatitis B, Gina.

A few days later.

Okay doc, hit me with it.

Well that’s something.

Shit.

On the plus side, you didn’t test positive for anything else. No HIV, no hep C, no chlamydia or other STIs.

But what about the hep B? What’s it gonna do to me? Is it gonna do my liver in?

Unlikely.

Your test has come back with “detected hep B surface antigen”.

In English? | don’t speak “doctor”.

6

It means you do have an active hep B Which might infection. explain why you’ve been feeling a bit off lately.

Yes, there’s a very high chance* your body will get rid of the virus and then you’ll be immune to it, but we’ll just have to wait and see.

Given what you’ve told me, it’s possible that the infection could be recent and acute.

If that’s the case, then there’s a very good chance your body will fight it off, but we won’t know for a few more months.

In the meantime, be careful if you cut yourself and start bleeding**.

And no unprotected sex. | also suggest you cut down on alcohol, sugar, and greasy, fried food just to give your liver a helping hand.

Fight it off?

* Up to 95% for most adults ** See page 13 for more info on what i to do in case of a blood spill

Jeeze doc, how long for?

When did you and Kapo last have unprotected sex?

A month ago maybe. | haven’t done it with anyone else since.

Okay. Let’s have you back for another blood test in about six months.

You shouldn’t have any symptoms worse than you’ve already experienced, but if you get a bad fever, feel really unwell or your eyes go yellow go to the hospital Emergency Department right away.

Sure thing, doc. | guess until then it’s business as usual?

|’ve got my electrician course and apprenticeship.

My friend Fatima says | won’t give her hep B by touching stuff or food?

Yes, that’s right, and don’t let anyone tell you any different.

7

How awesome we’re both junior electricians now.

Six months later.

| know!

We showed them boys alright.

Hey, “Ms Sparky”!

Hey you too, “Ms Sparky”!

Oh Gina, that’s great news! |’m so happy to hear that.

Yeah! And something else good |’ve just found out, |’ve cleared my hep B... it’s gone for good and |’m immune now.

And the sweetest thing | know is the baklava at my aunt Zahra’s pastry sweets shop.

It’s not far.

Sounds great!

Look out Aunty Zahra, here we come!

News that sweet deserves to be celebrated.

8

END!

Hep B can be prevented with a

safe & effective vaccine!

The hep B vaccine is safe and effective, and recommended for all babies at birth and for young people up to 18 years.

The hep B vaccine is also recommended for adults living with diabetes and those at high risk for transmission due to their jobs, lifestyle, living situations, or country of birth, including but not limited to: n sexual partners of people with acute and/or chronic hep B n household members of people with acute and chronic hep B n people with HIV or weakened immune systems n Aboriginal and Torres Strait Islander people* n people who have migrated from countries where hep B is common* n people who inject drugs and/or steroids * n sex workers* n men who have sex with men* n recipients of certain blood products* n individuals with chronic liver disease and/or hep C * n inmates and staff from long-term correctional facilities* n people who play contact sports (eg football, soccer, hockey, etc) n tattooists and body-piercers

*consider having combined hep A/hep B vaccine

WHO & WHEN

You cannot get hep B from the vaccine. The Hep B vaccine is made without blood products. Side effects are rare.

Since 1 May 2000, babies get a hep B vaccine shortly after birth while in hospital with further doses at two, four and six months of age.

Young people between 11 and 15 years old usually get a two-dose course of adult hep B vaccine given four to six months apart.

In order to get full protection against hep B, adults should have three doses of the vaccine at zero, one and six months.

A blood test, to see if the vaccine has worked to protect against hep B, is recommended four weeks after the third dose of the hep B vaccine.

9

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OUCH. CLEANING UP A...

BlOOD SPILL A

ccidents can happen! If you're living with hepatitis B you and the people around you will need to be extra careful if an accident - maybe a cut - also results in your blood being spilled. Hopefully it is just a little nick or a small cut and there isn't too much blood, even so it'll need to be cleaned up properly to avoid the risk of transmission.

SPOT CLEAN S Put on disposable rubber gloves...

S Wipe up spot immediately with a damp cloth, tissue or paper towel...

S Put materials in a plastic bag, tie off and dispose of in a bin...

S Wash hands thoroughly.

ALL SPILLS (up to 10cm diameter) S Put on disposable rubber gloves, and if appropriate, other protective equipment (for example, apron, safety glasses, etc)...

S Wipe up spill immediately with absorbent material...

S Place contaminated material into a plastic bag, tie off and dispose of in a bin...

S Clean the area with warm detergent solution, using disposable cloth or sponge...

S Wipe the area with bleach and allow to dry...

S Wash hands thoroughly.

13

HEP B TESTING

ASK YOUR DOCTOR TO TEST IF YO

HEP B TEST RESULTS WILL

A CURRENT INFECTION - YOU HAVE HEP B RIGHT NOW.

IMMUN YOU HAV AND AR YOU C

2ND HEP B TEST (6 MONTHS LATER) TAKE THE TEST AGAIN TO SEE IF YOU STILL HAVE HEP B (IF YOU HAVE HEP B LONGER THAN 6 MONTHS IT MEANS YOUR BODY CAN’T FIGHT IT OFF).

CHRONIC HEP B YOU HAVE HAD HEP B FOR MORE THAN 6 MONTHS. THIS MEANS YOU WILL HAVE HEP B FOR LIFE.

RESOLVED HEP B INFECTION YOU HAD HEP B BUT YOUR BODY FOUGHT IT OFF. YOU CAN’T GET HEP B AGAIN.

CHECK-UPS EVERY 6 MONTHS TO STAY HEALTHY, IT’S IMPORTANT TO BOOK REGULAR CHECK-UPS WITH YOUR DOCTOR. THEY WILL TALK TO YOU ABOUT TREATMENT OPTIONS.

YOUR SEXUAL PARTNERS OR FAMILY MIGHT HAVE HEP B TOO. TALK TO THEM ABOUT GETTING TESTED.

*

NO A YOU AGA C

6

MONTHS

*IF YOU HAVE HEP B FOR LIFE 14

People with hep B can live long, healthy lives. To make sure you stay as healthy as you can, it is doctor every 6-12 months. At your check-up, your doctor will do a blood test and sometimes a your liver is healthy and work out if you should be on treatment. They will also talk to you about

G FOR ADULTS

OU HAVE HEP B OR ARE IMMUNE

TELL YOU IF YOU HAVE...

NITY (VACCINATION) VE BEEN VACCINATED RE IMMUNE TO HEP B. CAN’T GET HEP B.

ACTION NEEDED U ARE PROTECTED AINST HEP B AND CAN’T GET IT.

IMMUNITY (PAST INFECTION) YOU ARE IMMUNE TO HEP B. YOU HAD HEP B IN THE PAST, BUT YOUR BODY FOUGHT IT OFF. YOU CAN’T GET HEP B AGAIN.

YOUR FAMILY MIGHT HAVE HEP B TOO. TALK TO THEM ABOUT GETTING TESTED.

s important that you have check-ups with your liver scan. Check-ups help your doctor make sure t what you can do to help keep your liver healthy.

NO IMMUNITY YOU DON’T HAVE HEP B, BUT YOU COULD STILL GET IT.

GET VACCINATED FOR HEP B ASK YOUR DOCTOR OR NURSE, COMMUNITY HEALTH CLINIC, SEXUAL HEALTH CLINIC, TRAVEL CLINIC OR AMS ABOUT GETTING VACCINATED.

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LOOKING FOR MORE TO READ? ALL PAST ISSUES ARE ONLINE AT: hep.org.au/news-stand

TRANSMISSION #19

TRANSMISSION #20

TRANSMISSION #21

TRANSMISSION #23

TX! MAG #24

TX! MAG #25

Game On Mitch & Bob are in JJ. Bob has hep C and Mitch worries he may have gotten it through a bloody fist fight on the footy field.

Need-To-Know Frank has been sent to prison for a three year stretch – while he’s inside he struggles with indecision about whether to get himself tested for hep C or not.

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Guys Like Us Daz, who is HIV+, accidently uses injecting equipment that had been used by someone else, did he get hep C? Only a test will tell.

Change Of Plans Lola is in prison for only a few weeks when she gets a tattoo with a pre-used and unsterile needle... not much later she finds out she now has hep C too.

The Way We Are Vic & Andy want to build a family together but it’s complicated by the difficulty Andy is having getting a job after being released from prison…

Ch-ch-changes Sam and Clara have both been living with hep C for a long time. Sam has even tried interferon but without luck. Will the new treatments change all that for them?

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END!

PHASES of CHRONIC

HEP B each phase can last for years but can suddenly change

1 2 3 4

Immune tolerant The body doesn't react against the hep B virus, even though it is multiplying inside the liver. At this stage there is usually no need for treatment, but regular monitoring is needed in case phase 2 happens...

Immune clearance The body's immune system tries to clear the virus, this can in some cases cause damage to the liver.

Treatment might be considered at this stage if there is a risk of damage to the liver.

Immune CONTROL The body has the virus back under control, but it is still present in the liver, and in blood and sexual fluids.

Usually there is no need for treatment if none was started in phase 2. Regular monitoring is needed in case phase 4 happens...

Immune escape In some people the virus may escape from immune control and the body's immune system will again attack the hep B leading to the risk of liver damage.

There is usually a need for treatment to happen in this phase.

25

BEING TESTED FOR HEP B! You cannot tell if you (or someone else) has hep B just by looking or because of "symptoms". The only way to know 100% for sure if you have hep B is by having a Hepatitis B Blood Test.

Because hep B is a complex virus three tests may be needed to determine your current status... but that can and should be done through one blood test. TALK TO YOUR GP.

Test name HEP B SURFACE ANTIGEN Acronym HBsAG What's it for? This test shows whether a person has a

current hep B infection Test name HEP B CORE ANTIBODY Acronym anti-HBc What's it for? This test shows whether a person has been

exposed to hep B either recently or in the past Test name HEP B SURFACE ANTIBODY ACRONYM anti-HBs What's it for? This test shows whether a person has

immunity to the hep B

CROSSWORD 1 TARGET S E I H T P T A I

How many words of four letters or more can you make from the letters here? In making a word, each letter may be used once only. Each word must contain the centre letter, and there must be at least one nine-letter word. No foreign words, no words with initial capitals and no hyphenated words.

ACROSS 1. Not even; weird (3) 3. Make an offer in an auction (3) 5. Huge Australian bird (3) 6. Not many (3) 8. Some thing to chew... and chew... and chew (3) 10. Little round green vegie from a pod (3) 12. Honey making insect (3) 14. 1+1= ... (3) 15. Baked dish; top & base of pastry with filling (3) 16. A dog does this with its tail (3)

DOWN 1. Not on; rotten (3) 2. Early morning drops of water on the ground (3) 3. Any kind of insect; annoy (3) 4. Massive water storage (3) 7. Night before; the "first woman" (3) 9. Employ, operate (3) 10. Burst a balloon! (3) 11. Devoured, consumed (3) 12. Used to shoot an arrow (3) 13. It's laid by a chook! (3) Solution next page

What's your score?

5 Meh. But at least you tried!

13 Pretty good, eh?

22 Awesome 41 Holy crap! Mega genius!

92 You are clearly a human dictionary and/or computer...we didn't even know half of those crazy words!

Answers next page

27

CROSSWORD 2 SOLUTION

E L E P H A N T S

L E X N T R E M E E L L Y

V R A D

E N X A N C T L L E G L O

H S C E A R O E U T S E

I N S I D E R

CROSSWORD1 SOLUTION

O D D B I D F E M U A F E W G U M V S P E A B E E O T W O G P I E W A G

28 Solution at right (no peeking now!!)

1. Long nosed animals (9) 2. Much, much more! (9) 3. Spot on. Accurate. (5) 5. Within something. (6) 6. Shock with a "BOO!!" (5) 10. Plastic building blocks for kids (4) 12. Worker's sturdy work vehicle (3) 1. More than 10, less than 12 (6) 4. Hello! (2) 7. Doorways. Bewitches. (9) 8. Gobble. Consume (3) 9. Needed for fishing (3) 10. A French word for "the"... (2) 11. Sharp sewing tool (6) 13. Cunning. Stalone. (3) 14. Someone who didn't win or never succeeds (5)

TARGET SOLUTION (red=more common) hepatitis, pithiest, atheist, patties, pettish, pietist, aptest, pattie, pietas, pities, pittas, spathe, theist, thetas, tithes, haste, hates, heats, heist, paste, pates, paths, petit, pieta, piste, pitas, piths, pitta, saith, septa, spate, spite, staph, state, stipe, tapes, tapis, taste, teats, testa, teths, theta, tipis, tithe, titis, east, eats, etas, hast, hate, hats, heat, hest, hits, past, pate, path, pats, peat, pest, pets, phat, piet, pita, pith, pits, sate, sati, seat, sept, sett, shat, shit, site, spat, spit, step, stet, tape, taps, tats, teas, teat, test, teth, that, this, ties, tipi, tips, titi, tits

A little bit harder...!

HEP B. COULD IT BE ME?

1800 803 990 HEPB.ORG.AU